<!DOCTYPE html>
<html lang="zh" xmlns:th="http://www.thymeleaf.org" xmlns:shiro="http://www.pollix.at/thymeleaf/shiro">
<head>
    <th:block th:include="include :: header('学生项目管理')"/>
    <th:block th:include="include :: summernote-css"/>
    <th:block th:include="include :: select2-css"/>
    <th:block th:include="include :: bootstrap-select-css"/>
    <th:block th:include="include :: datetimepicker-css"/>
</head>
<body class="gray-bg">
<div class="container-div">
    <form id="formData">
        <input name="childId" type="hidden" th:value="${childId}"/>
        <table cellspacing="5" th:if="*{basicInformation != null}">
            <tr>
                <td align="right" style="font-weight:600;">儿童姓名：</td>
                <td align="left"><input name="childName" th:value="${basicInformation.childName}" readonly="readonly"/>
                </td>
                <td align="right" style="font-weight:600;">儿童性别：</td>
                <td align="left" id="sex"><input name="childSex" th:value="${basicInformation.childSex}"
                                                 readonly="readonly"/></td>
                <td align="right" style="font-weight:600;">儿童年龄：</td>
                <td align="left" id="age"><input name="childAge" th:value="${basicInformation.childAge}"
                                                 readonly="readonly"/></td>
            </tr>
            <tbody id="imfor">
            <tr>
                <td align="right" style="font-weight:600;">家长姓名：</td>
                <td align="left"><input name="parentName" th:value="${basicInformation.parentName}"/></td>
                <td align="right" style="font-weight:600;">家长电话：</td>
                <td align="left"><input name="parentPhone" th:value="${basicInformation.parentPhone}"/></td>
                <td align="right" style="font-weight:600;">家长年龄：</td>
                <td align="left"><input name="parentAge" th:value="${basicInformation.parentAge}"/></td>
            </tr>
            <tr>
                <td align="right" style="font-weight:600;">家长工作：</td>
                <td align="left" colspan="5" th:text="${basicInformation.parentJob}"></td>
            </tr>
            <tr>
                <td align="right" style="font-weight:600;" rowspan="2">就学情况：</td>
                <td align="left" colspan="5">
                    <input type="radio" name="learnSituation" value="15" id="learnSituation1"
                           th:attr="checked=${basicInformation.learnSituation == 15?true:false}"/>未就学
                    <input type="radio" name="learnSituation" value="16" id="learnSituation2"
                           th:attr="checked=${basicInformation.learnSituation == 16?true:false}"/>训练机构
                    <input type="radio" name="learnSituation" value="17" id="learnSituation3"
                           th:attr="checked=${basicInformation.learnSituation == 17?true:false}"/>普通幼儿园
                    <input type="radio" name="learnSituation" value="18" id="learnSituation4"
                           th:attr="checked=${basicInformation.learnSituation == 18?true:false}"/>特殊幼儿园
                    <input type="radio" name="learnSituation" value="19" id="learnSituation5"
                           th:attr="checked=${basicInformation.learnSituation == 19?true:false}"/>普通小学
                    <input type="radio" name="learnSituation" value="20" id="learnSituation6"
                           th:attr="checked=${basicInformation.learnSituation == 20?true:false}"/>特殊学校
                    <input type="radio" name="learnSituation" value="21" id="learnSituation7"
                           th:attr="checked=${basicInformation.learnSituation == 21?true:false}"/>其他
                    <span style="margin-left:12px;">备注：<input class="input-text" type="text" id="learnSituationRemark"
                                                              name="learnSituationRemark"
                                                              th:value="${basicInformation.learnSituationRemark}"></span>
                </td>
            </tr>
            <tr>
                <td class="firstTd">家庭排序：</td>
                <td align="left" colspan="5">
                    <input type="radio" name="familySort" id="familySort1" value="22"
                           th:attr="checked=${basicInformation.familySort == 22?true:false}"/>头胎
                    <input type="radio" name="familySort" id="familySort2" value="23"
                           th:attr="checked=${basicInformation.familySort == 23?true:false}"/>二胎
                    <input type="radio" name="familySort" id="familySort3" value="24"
                           th:attr="checked=${basicInformation.familySort == 24?true:false}"/>三胎
                </td>
            </tr>
            <tr>
                <td class="firstTd">主要语言：</td>
                <td align="left" colspan="5" th:each="mainLanguage : ${basicInformation.mainLanguage}">
                    <input type="checkbox" name="mainLanguage" value="1"
                           th:attr="checked=${mainLanguage == '1'?true:false}"/>普通话
                    <input type="checkbox" name="mainLanguage" value="2"
                           th:attr="checked=${mainLanguage == '2'?true:false}"/>方言
                    <input type="checkbox" name="mainLanguage" value="3"
                           th:attr="checked=${mainLanguage == '3'?true:false}"/>其他
                    <span style="margin-left:12px;">备注：<input type="text" class="input-text" id="mainLanguageRemark"
                                                              name="mainLanguageRemark"
                                                              th:value="${basicInformation.mainLanguageRemark}"/></span>
                </td>
            </tr>
            <tr>
                <td rowspan="2" class="firstTd" th:each="medicalDiagnosis:${basicInformation.medicalDiagnosis}">医学诊断：
                </td>
                <span th:switch="${medicalDiagnosis}">
                            <input type="checkbox" name="medicalDiagnosis" value="30" th:case="30"
                                   th:attr="checked=${true}"/>  未诊断
                            <input type="checkbox" name="medicalDiagnosis" value="31" th:case="31"
                                   th:attr="checked=${true}"/>自闭症倾向
                            <input type="checkbox" name="medicalDiagnosis" value="32" th:case="32"
                                   th:attr="checked=${true}"/>自闭症谱系障碍
                            <input type="checkbox" name="medicalDiagnosis" value="33" th:case="33"
                                   th:attr="checked=${true}"/>艾斯伯格综合征
                            <input type="checkbox" name="medicalDiagnosis" value="34" th:case="34"
                                   th:attr="checked=${true}"/>发育迟缓(包括语言、社交性迟缓)
                </span>
            </tr>
            <tr>
                <!--<td align="left" colspan="5" th:each="medicalDiagnosis : ${basicInformation.medicalDiagnosis[0]}">
                    <input type="checkbox" name="medicalDiagnosis" value="30"
                           th:attr="checked=${basicInformation.medicalDiagnosis[0] eq '30'||basicInformation.medicalDiagnosis[1] eq '30'||basicInformation.medicalDiagnosis[2] eq '30'||basicInformation.medicalDiagnosis[3] eq '30'||basicInformation.medicalDiagnosis[4] eq '30'?true:false}"/>智力发育障碍
                    <input type="checkbox" name="medicalDiagnosis" value="31"
                           th:attr="checked=${basicInformation.medicalDiagnosis[0] eq '31'||basicInformation.medicalDiagnosis[1] eq '31'||basicInformation.medicalDiagnosis[2] eq '31'||basicInformation.medicalDiagnosis[3] eq '31'||basicInformation.medicalDiagnosis[4] eq '31'?true:false}"/>学习障碍
                    <input type="checkbox" name="medicalDiagnosis" value="32"
                           th:attr="checked=${basicInformation.medicalDiagnosis[0] eq '32'||basicInformation.medicalDiagnosis[1] eq '32'||basicInformation.medicalDiagnosis[2] eq '32'||basicInformation.medicalDiagnosis[3] eq '32'||basicInformation.medicalDiagnosis[4] eq '32'?true:false}"/>语言障碍
                    <input type="checkbox" name="medicalDiagnosis" value="33"
                           th:attr="checked=${basicInformation.medicalDiagnosis[0] eq '33'||basicInformation.medicalDiagnosis[1] eq '33'||basicInformation.medicalDiagnosis[2] eq '33'||basicInformation.medicalDiagnosis[3] eq '33'||basicInformation.medicalDiagnosis[4] eq '33'?true:false}"/>情绪行为障碍
                    <input type="checkbox" name="medicalDiagnosis" value="34"
                           th:attr="checked=${basicInformation.medicalDiagnosis[0] eq '34'||basicInformation.medicalDiagnosis[1] eq '34'||basicInformation.medicalDiagnosis[2] eq '34'||basicInformation.medicalDiagnosis[3] eq '34'||basicInformation.medicalDiagnosis[4] eq '34'?true:false}"/>其他
                    <span style="margin-left:12px;">备注：<input class="input-text" type="text" id="medicalDiagnosisRemark"
                                                              name="medicalDiagnosisRemark"
                                                              th:value="${basicInformation.medicalDiagnosisRemark}"/></span>
                </td>-->
            </tr>
            <tr>
                <td rowspan="2" class="firstTd">家族遗传病：</td>
                <td align="left" colspan="5">
                    <input type="checkbox" name="familyHereditaryDisease" value="4"
                           th:attr="checked=${basicInformation.familyHereditaryDisease == '4'?true:false}"/>哮喘
                    <input type="checkbox" name="familyHereditaryDisease" value="5"
                           th:attr="checked=${basicInformation.familyHereditaryDisease == '5'?true:false}"/>先天性聋哑
                    <input type="checkbox" name="familyHereditaryDisease" value="6"
                           th:attr="checked=${basicInformation.familyHereditaryDisease == '6'?true:false}"/>精神分裂症
                    <input type="checkbox" name="familyHereditaryDisease" value="7"
                           th:attr="checked=${basicInformation.familyHereditaryDisease == '7'?true:false}"/>智力障碍
                    <input type="checkbox" name="familyHereditaryDisease" value="8"
                           th:attr="checked=${basicInformation.familyHereditaryDisease == '8'?true:false}"/>心脏病
                    <input type="checkbox" name="familyHereditaryDisease" value="9"
                           th:attr="checked=${basicInformation.familyHereditaryDisease == '9'?true:false}"/>糖尿病
                    <input type="checkbox" name="familyHereditaryDisease" value="10"
                           th:attr="checked=${basicInformation.familyHereditaryDisease == '10'?true:false}"/>白化病
                </td>
            </tr>
            <tr>
                <td align="left" colspan="5">
                    <input type="checkbox" name="familyHereditaryDisease" value="11"
                           th:attr="checked=${basicInformation.familyHereditaryDisease == '11'?true:false}"/>高血脂
                    <input type="checkbox" name="familyHereditaryDisease" value="12"
                           th:attr="checked=${basicInformation.familyHereditaryDisease == '12'?true:false}"/>高血压
                    <input type="checkbox" name="familyHereditaryDisease" value="13"
                           th:attr="checked=${basicInformation.familyHereditaryDisease == '13'?true:false}"/>血友病
                    <input type="checkbox" name="familyHereditaryDisease" value="14"
                           th:attr="checked=${basicInformation.familyHereditaryDisease == '14'?true:false}"/>其他
                    <span style="margin-left:12px">备注：<input class="input-text" type="text" id="hereditaryDiseaseRemark"
                                                             name="hereditaryDiseaseRemark"
                                                             th:value="${basicInformation.hereditaryDiseaseRemark}"/></span>
                </td>
            </tr>
            <tr>
                <td rowspan="3" class="firstTd">孕期特殊情况：</td>
                <td align="left" colspan="5">
                    <input type="checkbox" name="pregnantSituation" value="35"
                           th:attr="checked=${basicInformation.pregnantSituation == '35'?true:false}"/>先兆流产
                    <input type="checkbox" name="pregnantSituation" value="36"
                           th:attr="checked=${basicInformation.pregnantSituation == '36'?true:false}"/>严重孕吐
                    <input type="checkbox" name="pregnantSituation" value="37"
                           th:attr="checked=${basicInformation.pregnantSituation == '37'?true:false}"/>妊娠高血糖
                    <input type="checkbox" name="pregnantSituation" value="38"
                           th:attr="checked=${basicInformation.pregnantSituation == '38'?true:false}"/>妊娠高血压
                    <input type="checkbox" name="pregnantSituation" value="39"
                           th:attr="checked=${basicInformation.pregnantSituation == '39'?true:false}"/>孕期出血
                    <input type="checkbox" name="pregnantSituation" value="40"
                           th:attr="checked=${basicInformation.pregnantSituation == '40'?true:false}"/>孕期严重贫血
                    <input type="checkbox" name="pregnantSituation" value="41"
                           th:attr="checked=${basicInformation.pregnantSituation == '41'?true:false}"/>孕期服药
                </td>
            </tr>
            <tr>
                <td align="left" colspan="5">
                    <input type="checkbox" name="pregnantSituation" value="42"
                           th:attr="checked=${basicInformation.pregnantSituation == '42'?true:false}"/>甲状腺功能异常
                    <input type="checkbox" name="pregnantSituation" value="43"
                           th:attr="checked=${basicInformation.pregnantSituation == '43'?true:false}"/>孕期饮酒或抽烟
                    <input type="checkbox" name="pregnantSituation" value="44"
                           th:attr="checked=${basicInformation.pregnantSituation == '44'?true:false}"/>其他
                    甲状腺功能异常备注：<input type="text" class="input-text" id="abnormalThyroidFunction"
                                     name="abnormalThyroidFunction"
                                     th:value="${basicInformation.abnormalThyroidFunction}"/>
                </td>
            </tr>
            <tr>
                <td align="left" colspan="5">
                    孕期服药备注：<input type="text" class="input-text" id="pregnantMedicine" name="pregnantMedicine"
                                  th:value="${basicInformation.pregnantEmotionRemark}"/>
                    孕期特殊情况备注：<input type="text" class="input-text" id="pregnantSituationRemark"
                                    name="pregnantSituationRemark"
                                    th:value="${basicInformation.pregnantSituationRemark}"/>
                </td>
            </tr>
            <tr>
                <td class="firstTd">孕期情绪状态：</td>
                <td align="left" colspan="5">
                    <input type="checkbox" name="pregnantEmotion" value="45"
                           th:attr="checked=${basicInformation.pregnantSituation == '45'?true:false}"/>焦虑
                    <input type="checkbox" name="pregnantEmotion" value="46"
                           th:attr="checked=${basicInformation.pregnantSituation == '46'?true:false}"/>抑郁
                    <input type="checkbox" name="pregnantEmotion" value="47"
                           th:attr="checked=${basicInformation.pregnantSituation == '47'?true:false}"/>烦躁
                    <input type="checkbox" name="pregnantEmotion" value="48"
                           th:attr="checked=${basicInformation.pregnantSituation == '48'?true:false}"/>依赖
                    <input type="checkbox" name="pregnantEmotion" value="49"
                           th:attr="checked=${basicInformation.pregnantSituation == '49'?true:false}"/>易激惹
                    <input type="checkbox" name="pregnantEmotion" value="50"
                           th:attr="checked=${basicInformation.pregnantSituation == '50'?true:false}"/>不安
                    <input type="checkbox" name="pregnantEmotion" value="51"
                           th:attr="checked=${basicInformation.pregnantSituation == '51'?true:false}"/>恐惧
                    <input type="checkbox" name="pregnantEmotion" value="52"
                           th:attr="checked=${basicInformation.pregnantSituation == '52'?true:false}"/>其他
                    备注：<input class="input-text" type="text" id="pregnantEmotionRemark" name="pregnantEmotionRemark"
                              th:value="${basicInformation.pregnantEmotionRemark}"/>
                </td>
            </tr>
            <tr>
                <td class="firstTd">生产方式：</td>
                <td align="left" colspan="5">
                    <input type="radio" name="productionMethod" id="productionMethod1" value="53"
                           th:attr="checked=${basicInformation.productionMethod == '53'?true:false}"/>顺产
                    <input type="radio" name="productionMethod" id="productionMethod2" value="54"
                           th:attr="checked=${basicInformation.productionMethod == '54'?true:false}"/>剖腹产
                    <input type="radio" name="productionMethod" id="productionMethod3" value="55"
                           th:attr="checked=${basicInformation.productionMethod == '55'?true:false}"/>顺转剖
                </td>
            </tr>
            <tr>
                <td class="firstTd">生产期间特殊情况：</td>
                <td align="left" colspan="5">
                    <input type="checkbox" name="productionSpecialSituation" value="56"
                           th:attr="checked=${basicInformation.productionSpecialSituation == '56'?true:false}"/>缺氧难产
                    <input type="checkbox" name="productionSpecialSituation" value="57"
                           th:attr="checked=${basicInformation.productionSpecialSituation == '57'?true:false}"/>脐带绕颈
                    <input type="checkbox" name="productionSpecialSituation" value="58"
                           th:attr="checked=${basicInformation.productionSpecialSituation == '58'?true:false}"/>胎儿过大
                    <input type="checkbox" name="productionSpecialSituation" value="59"
                           th:attr="checked=${basicInformation.productionSpecialSituation == '59'?true:false}"/>宫缩乏力
                    <input type="checkbox" name="productionSpecialSituation" value="60"
                           th:attr="checked=${basicInformation.productionSpecialSituation == '60'?true:false}"/>胎盘早期剥离
                    <input type="checkbox" name="productionSpecialSituation" value="64"
                           th:attr="checked=${basicInformation.productionSpecialSituation == '61'?true:false}"/>产程延长<input
                        type="checkbox" name="productionSpecialSituation" value="62"
                        th:attr="checked=${basicInformation.productionSpecialSituation == 62?true:false}"/>胎膜早破
                    <input type="checkbox" name="productionSpecialSituation" value="63"
                           th:attr="checked=${basicInformation.productionSpecialSituation == '63'?true:false}"/>宫内感染
                    <input type="checkbox" name="productionSpecialSituation" value="64"
                           th:attr="checked=${basicInformation.productionSpecialSituation == '64'?true:false}"/>羊水栓塞
                </td>
            </tr>
            <tr>
                <td class="firstTd">产后情况：</td>
                <td align="left" colspan="5">
                    <input type="checkbox" name="afterProductionSituation" value="65"
                           th:attr="checked=${basicInformation.afterProductionSituation == '65'?true:false}"/>产后抑郁
                    <input type="checkbox" name="afterProductionSituation" value="66"
                           th:attr="checked=${basicInformation.afterProductionSituation == '66'?true:false}"/>产后大出血
                    <input type="checkbox" name="afterProductionSituation" value="67"
                           th:attr="checked=${basicInformation.afterProductionSituation == '67'?true:false}"/>产后精神病
                    <input type="checkbox" name="afterProductionSituation" value="68"
                           th:attr="checked=${basicInformation.afterProductionSituation == '68'?true:false}"/>其他
                    备注：<input class="input-text" type="text" id="afterProductionRemark" name="afterProductionRemark"
                              th:value="${basicInformation.afterProductionRemark}"/>
                </td>
            </tr>
            <tr>
                <td class="firstTd">主要照料者：</td>
                <td align="left" colspan="5">
                    <input type="checkbox" name="mainCaregiver" value="69"
                           th:attr="checked=${basicInformation.afterProductionSituation == '69'?true:false}"/>保姆
                    <input type="checkbox" name="mainCaregiver" value="70"
                           th:attr="checked=${basicInformation.afterProductionSituation == '70'?true:false}"/>亲生父母
                    <input type="checkbox" name="mainCaregiver" value="71"
                           th:attr="checked=${basicInformation.afterProductionSituation == '71'?true:false}"/>养父母
                    <input type="checkbox" name="mainCaregiver" value="72"
                           th:attr="checked=${basicInformation.afterProductionSituation == '72'?true:false}"/>爷爷奶奶
                    <input type="checkbox" name="mainCaregiver" value="73"
                           th:attr="checked=${basicInformation.afterProductionSituation == '73'?true:false}"/>外公外婆
                </td>
            </tr>
            <tr>
                <td class="firstTd">意外身体伤害：</td>
                <td align="left" colspan="5">
                    <input type="checkbox" name="accidentPhysicalInjury" value="74"
                           th:attr="checked=${basicInformation.afterProductionSituation == '74'?true:false}"/>严重摔伤
                    <input type="checkbox" name="accidentPhysicalInjury" value="75"
                           th:attr="checked=${basicInformation.afterProductionSituation == '75'?true:false}"/>休克
                    <input type="checkbox" name="accidentPhysicalInjury" value="76"
                           th:attr="checked=${basicInformation.afterProductionSituation == '76'?true:false}"/>癫痫
                    <input type="checkbox" name="accidentPhysicalInjury" value="77"
                           th:attr="checked=${basicInformation.afterProductionSituation == '77'?true:false}"/>其他
                    备注：<input class="input-text" type="text" id="physicalInjuryRemark" name="physicalInjuryRemark"
                              th:value="${basicInformation.physicalInjuryRemark}"/>
                </td>
            </tr>
            <tr>
                <td class="firstTd">意外家庭变动：</td>
                <td align="left" colspan="5">
                    <input type="checkbox" name="accidentFamilyChanges" value="78"
                           th:attr="checked=${basicInformation.accidentFamilyChanges == '78'?true:false}"/>父母离异
                    <input type="checkbox" name="accidentFamilyChanges" value="79"
                           th:attr="checked=${basicInformation.accidentFamilyChanges == '79'?true:false}"/>亲人去世
                    <input type="checkbox" name="accidentFamilyChanges" value="80"
                           th:attr="checked=${basicInformation.accidentFamilyChanges == '80'?true:false}"/>其他
                    备注：<input class="input-text" type="text" id="familyChangesRemark" name="familyChangesRemark"
                              th:value="${basicInformation.familyChangesRemark}"/>
                </td>
            </tr>
            <tr>
                <td class="firstTd">一类疫苗：</td>
                <td align="left" colspan="5">
                    <input type="checkbox" name="oneTypeVaccines" value="81"
                           th:attr="checked=${basicInformation.oneTypeVaccines == '81'?true:false}"/>卡介苗
                    <input type="checkbox" name="oneTypeVaccines" value="82"
                           th:attr="checked=${basicInformation.oneTypeVaccines == '82'?true:false}"/>脊髓灰质炎疫苗
                    <input type="checkbox" name="oneTypeVaccines" value="83"
                           th:attr="checked=${basicInformation.oneTypeVaccines == '83'?true:false}"/>麻疹疫苗
                    <input type="checkbox" name="oneTypeVaccines" value="84"
                           th:attr="checked=${basicInformation.oneTypeVaccines == '84'?true:false}"/>百白破疫苗
                    <input type="checkbox" name="oneTypeVaccines" value="85"
                           th:attr="checked=${basicInformation.oneTypeVaccines == '85'?true:false}"/>乙肝疫苗
                </td>
            </tr>
            <tr>
                <td class="firstTd">二类疫苗：</td>
                <td align="left" colspan="5">
                    <input type="checkbox" name="twoTypeVaccines" value="86"
                           th:attr="checked=${basicInformation.twoTypeVaccines == '86'?true:false}"/>流脑疫苗
                    <input type="checkbox" name="twoTypeVaccines" value="87"
                           th:attr="checked=${basicInformation.twoTypeVaccines == '87'?true:false}"/>麻腮风三联
                    <input type="checkbox" name="twoTypeVaccines" value="88"
                           th:attr="checked=${basicInformation.twoTypeVaccines == '88'?true:false}"/>水痘
                    <input type="checkbox" name="twoTypeVaccines" value="89"
                           th:attr="checked=${basicInformation.twoTypeVaccines == '89'?true:false}"/>肺炎球菌
                    <input type="checkbox" name="twoTypeVaccines" value="90"
                           th:attr="checked=${basicInformation.twoTypeVaccines == '90'?true:false}"/>流感
                    <input type="checkbox" name="twoTypeVaccines" value="91"
                           th:attr="checked=${basicInformation.twoTypeVaccines == '91'?true:false}"/>甲肝疫苗
                </td>
            </tr>
            <tr>
                <td class="firstTd">其他疫苗：</td>
                <td align="left" colspan="5">
                    <input class="input-text" type="text" id="otherVaccines" name="otherVaccines" style="width:500px;"/>
                </td>
            </tr>
            <tr>
                <td class="firstTd">食物过敏：</td>
                <td align="left" colspan="5">
                    <input type="checkbox" name="foodAllergy" value="92"
                           th:attr="checked=${basicInformation.foodAllergy == '92'?true:false}"/>鸡蛋
                    <input type="checkbox" name="foodAllergy" value="93"
                           th:attr="checked=${basicInformation.foodAllergy == '93'?true:false}"/>牛奶
                    <input type="checkbox" name="foodAllergy" value="94"
                           th:attr="checked=${basicInformation.foodAllergy == '94'?true:false}"/>坚果
                    <input type="checkbox" name="foodAllergy" value="95"
                           th:attr="checked=${basicInformation.foodAllergy == '95'?true:false}"/>花生
                    <input type="checkbox" name="foodAllergy" value="96"
                           th:attr="checked=${basicInformation.foodAllergy == '96'?true:false}"/>黄豆
                    <input type="checkbox" name="foodAllergy" value="97"
                           th:attr="checked=${basicInformation.foodAllergy == '97'?true:false}"/>鱼
                    <input type="checkbox" name="foodAllergy" value="98"
                           th:attr="checked=${basicInformation.foodAllergy == '98'?true:false}"/>大米
                    <input type="checkbox" name="foodAllergy" value="99"
                           th:attr="checked=${basicInformation.foodAllergy == '99'?true:false}"/>其他
                    备注：<input class="input-text" type="text" id="foodAllergyRemark" name="foodAllergyRemark"
                              th:value="${basicInformation.foodAllergyRemark}"/>
                </td>
            </tr>
            <tr>
                <td class="firstTd">吸入性敏：</td>
                <td align="left" colspan="5">
                    <input type="checkbox" name="breathAllergy" value="100"
                           th:attr="checked=${basicInformation.breathAllergy == '100'?true:false}"/>扬尘
                    <input type="checkbox" name="breathAllergy" value="101"
                           th:attr="checked=${basicInformation.breathAllergy == '101'?true:false}"/>尘螨
                    <input type="checkbox" name="breathAllergy" value="102"
                           th:attr="checked=${basicInformation.breathAllergy == '102'?true:false}"/>香精
                    <input type="checkbox" name="breathAllergy" value="103"
                           th:attr="checked=${basicInformation.breathAllergy == '103'?true:false}"/>花粉
                    <input type="checkbox" name="breathAllergy" value="104"
                           th:attr="checked=${basicInformation.breathAllergy == '104'?true:false}"/>其他
                    备注：<input class="input-text" type="text" id="breathAllergyRemark" name="breathAllergyRemark"
                              th:value="${basicInformation.breathAllergyRemark}"/>
                </td>
            </tr>
            <tr>
                <td class="firstTd">接触性过敏：</td>
                <td align="left" colspan="5">
                    <input type="checkbox" name="contactAllergy" value="105"
                           th:attr="checked=${basicInformation.contactAllergy == '105'?true:false}"/>紫外线
                    <input type="checkbox" name="contactAllergy" value="106"
                           th:attr="checked=${basicInformation.contactAllergy == '106'?true:false}"/>洗洁精
                    <input type="checkbox" name="contactAllergy" value="107"
                           th:attr="checked=${basicInformation.contactAllergy == '107'?true:false}"/>特定金属制品
                    <input type="checkbox" name="contactAllergy" value="108"
                           th:attr="checked=${basicInformation.contactAllergy == '108'?true:false}"/>化纤制品
                    <input type="checkbox" name="contactAllergy" value="109"
                           th:attr="checked=${basicInformation.contactAllergy == '109'?true:false}"/>其他
                    备注：<input class="input-text" type="text" id="contactAllergyRemark" name="contactAllergyRemark"
                              th:value="${basicInformation.contactAllergyRemark}"/>
                </td>
            </tr>
            <tr>
                <td class="firstTd">肢体缺失：</td>
                <td align="left" colspan="5">
                    <input type="checkbox" name="limbDeletion" value="110"
                           th:attr="checked=${basicInformation.limbDeletion == '110'?true:false}"/>面部（五官）
                    <input type="checkbox" name="limbDeletion" value="111"
                           th:attr="checked=${basicInformation.limbDeletion == '111'?true:false}"/>上肢
                    <input type="checkbox" name="limbDeletion" value="112"
                           th:attr="checked=${basicInformation.limbDeletion == '112'?true:false}"/>手指
                    <input type="checkbox" name="limbDeletion" value="113"
                           th:attr="checked=${basicInformation.limbDeletion == '113'?true:false}"/>下肢
                    <input type="checkbox" name="limbDeletion" value="114"
                           th:attr="checked=${basicInformation.limbDeletion == '114'?true:false}"/>脚趾
                    <input type="checkbox" name="limbDeletion" value="115"
                           th:attr="checked=${basicInformation.limbDeletion == '115'?true:false}"/>其他
                    备注：<input class="input-text" type="text" id="limbDeletionRemark" name="limbDeletionRemark"
                              th:value="${basicInformation.limbDeletionRemark}"/>
                </td>
            </tr>
            <tr>
                <td class="firstTd">医学检查：</td>
                <td align="left" colspan="5">
                    <input type="checkbox" name="medicalExamination" value="116"
                           th:attr="checked=${basicInformation.medicalExamination == '116'?true:false}"/>核磁
                    <input type="checkbox" name="medicalExamination" value="117"
                           th:attr="checked=${basicInformation.medicalExamination == '117'?true:false}"/>CT
                    <input type="checkbox" name="medicalExamination" value="118"
                           th:attr="checked=${basicInformation.medicalExamination == '118'?true:false}"/>行为筛查
                    <input type="checkbox" name="medicalExamination" value="119"
                           th:attr="checked=${basicInformation.medicalExamination == '119'?true:false}"/>听统筛查
                    <input type="checkbox" name="medicalExamination" value="120"
                           th:attr="checked=${basicInformation.medicalExamination == '120'?true:false}"/>发育水平评估
                    <input type="checkbox" name="medicalExamination" value="121"
                           th:attr="checked=${basicInformation.medicalExamination == '121'?true:false}"/>其他
                    备注：<input class="input-text" type="text" id="medicalExaminationRemark"
                              name="medicalExaminationRemark" th:value="${basicInformation.medicalExaminationRemark}"/>
                </td>
            </tr>
            </tbody>
        </table>

        <table cellspacing="5" th:if="*{basicInformation == null}">
            <tr>
                <td align="right" style="font-weight:600;">儿童姓名：</td>
                <td align="left" id="childName" name="childName"></td>
                <td align="right" style="font-weight:600;">儿童性别：</td>
                <td align="left" id="sex"></td>
                <td align="right" style="font-weight:600;">儿童年龄：</td>
                <td align="left" id="age"></td>
            </tr>
            <tbody id="imfor">
            <tr>
                <td align="right" style="font-weight:600;">家长姓名：</td>
                <td align="left"></td>
                <td align="right" style="font-weight:600;">家长电话：</td>
                <td align="left"></td>
                <td align="right" style="font-weight:600;">家长年龄：</td>
                <td align="left"></td>
            </tr>
            <tr>
                <td align="right" style="font-weight:600;">家长工作：</td>
                <td align="left" colspan="5"></td>
            </tr>
            <tr>
                <td align="right" style="font-weight:600;" rowspan="2">就学情况：</td>
                <td align="left" colspan="5">
                    <input type="checkbox" name="learnSituation" value="15" id="learnSituation1"/>未就学
                    <input type="checkbox" name="learnSituation" value="16" id="learnSituation2"/>训练机构
                    <input type="checkbox" name="learnSituation" value="17" id="learnSituation3"/>普通幼儿园
                    <input type="checkbox" name="learnSituation" value="18" id="learnSituation4"/>特殊幼儿园
                    <input type="checkbox" name="learnSituation" value="19" id="learnSituation5"/>普通小学
                    <input type="checkbox" name="learnSituation" value="20" id="learnSituation6"/>特殊学校
                    <input type="checkbox" name="learnSituation" value="21" id="learnSituation7"/>其他
                    <span style="margin-left:12px;">备注：<input class="input-text" type="text" id="learnSituationRemark"
                                                              name="learnSituationRemark"></span>
                </td>
            </tr>
            <tr>
                <td class="firstTd">家庭排序：</td>
                <td align="left" colspan="5">
                    <input type="radio" name="familySort" id="familySort1" value="22"/>头胎
                    <input type="radio" name="familySort" id="familySort2" value="23"/>二胎
                    <input type="radio" name="familySort" id="familySort3" value="24"/>三胎
                </td>
            </tr>
            <tr>
                <td class="firstTd">主要语言：</td>
                <td align="left" colspan="5">
                    <input type="checkbox" name="mainLanguage" value="1"/>普通话
                    <input type="checkbox" name="mainLanguage" value="2"/>方言
                    <input type="checkbox" name="mainLanguage" value="3"/>其他
                    <span style="margin-left:12px;">备注：<input type="text" class="input-text" id="mainLanguageRemark"
                                                              name="mainLanguageRemark"/></span>
                </td>
            </tr>
            <tr>
                <td rowspan="2" class="firstTd">医学诊断：</td>
                <td align="left" colspan="5">
                    <input type="checkbox" name="medicalDiagnosis" value="25"/>未诊断
                    <input type="checkbox" name="medicalDiagnosis" value="26"/>自闭症倾向
                    <input type="checkbox" name="medicalDiagnosis" value="27"/>自闭症谱系障碍
                    <input type="checkbox" name="medicalDiagnosis" value="28"/>艾斯伯格综合征
                    <input type="checkbox" name="medicalDiagnosis" value="29"/>发育迟缓(包括语言、社交性迟缓)
            </tr>
            <tr>
                <td align="left" colspan="5">
                    <input type="checkbox" name="medicalDiagnosis" value="30"/>智力发育障碍
                    <input type="checkbox" name="medicalDiagnosis" value="31"/>学习障碍
                    <input type="checkbox" name="medicalDiagnosis" value="32"/>语言障碍
                    <input type="checkbox" name="medicalDiagnosis" value="33"/>情绪行为障碍
                    <input type="checkbox" name="medicalDiagnosis" value="34"/>其他
                    <span style="margin-left:12px;">备注：<input class="input-text" type="text" id="medicalDiagnosisRemark"
                                                              name="medicalDiagnosisRemark"/></span>
                </td>
            </tr>
            <tr>
                <td rowspan="2" class="firstTd">家族遗传病：</td>
                <td align="left" colspan="5">
                    <input type="checkbox" name="familyHereditaryDisease" value="4"/>哮喘
                    <input type="checkbox" name="familyHereditaryDisease" value="5"/>先天性聋哑
                    <input type="checkbox" name="familyHereditaryDisease" value="6"/>精神分裂症
                    <input type="checkbox" name="familyHereditaryDisease" value="7"/>智力障碍
                    <input type="checkbox" name="familyHereditaryDisease" value="8"/>心脏病
                    <input type="checkbox" name="familyHereditaryDisease" value="9"/>糖尿病
                    <input type="checkbox" name="familyHereditaryDisease" value="10"/>白化病
                </td>
            </tr>
            <tr>
                <td align="left" colspan="5">
                    <input type="checkbox" name="familyHereditaryDisease" value="11"/>高血脂
                    <input type="checkbox" name="familyHereditaryDisease" value="12"/>高血压
                    <input type="checkbox" name="familyHereditaryDisease" value="13"/>血友病
                    <input type="checkbox" name="familyHereditaryDisease" value="14"/>其他
                    <span style="margin-left:12px">备注：<input class="input-text" type="text" id="hereditaryDiseaseRemark"
                                                             name="hereditaryDiseaseRemark"/></span>
                </td>
            </tr>
            <tr>
                <td rowspan="3" class="firstTd">孕期特殊情况：</td>
                <td align="left" colspan="5">
                    <input type="checkbox" name="pregnantSituation" value="35"/>先兆流产
                    <input type="checkbox" name="pregnantSituation" value="36"/>严重孕吐
                    <input type="checkbox" name="pregnantSituation" value="37"/>妊娠高血糖
                    <input type="checkbox" name="pregnantSituation" value="38"/>妊娠高血压
                    <input type="checkbox" name="pregnantSituation" value="39"/>孕期出血
                    <input type="checkbox" name="pregnantSituation" value="40"/>孕期严重贫血
                    <input type="checkbox" name="pregnantSituation" value="41"/>孕期服药
                </td>
            </tr>
            <tr>
                <td align="left" colspan="5">
                    <input type="checkbox" name="pregnantSituation" value="42"/>甲状腺功能异常
                    <input type="checkbox" name="pregnantSituation" value="43"/>孕期饮酒或抽烟
                    <input type="checkbox" name="pregnantSituation" value="44"/>其他
                    甲状腺功能异常备注：<input type="text" class="input-text" id="abnormalThyroidFunction"
                                     name="abnormalThyroidFunction"/>
                </td>
            </tr>
            <tr>
                <td align="left" colspan="5">
                    孕期服药备注：<input type="text" class="input-text" id="pregnantMedicine" name="pregnantMedicine"/>
                    孕期特殊情况备注：<input type="text" class="input-text" id="pregnantSituationRemark"
                                    name="pregnantSituationRemark"/>
                </td>
            </tr>
            <tr>
                <td class="firstTd">孕期情绪状态：</td>
                <td align="left" colspan="5">
                    <input type="checkbox" name="pregnantEmotion" value="45"/>焦虑
                    <input type="checkbox" name="pregnantEmotion" value="46"/>抑郁
                    <input type="checkbox" name="pregnantEmotion" value="47"/>烦躁
                    <input type="checkbox" name="pregnantEmotion" value="48"/>依赖
                    <input type="checkbox" name="pregnantEmotion" value="49"/>易激惹
                    <input type="checkbox" name="pregnantEmotion" value="50"/>不安
                    <input type="checkbox" name="pregnantEmotion" value="51"/>恐惧
                    <input type="checkbox" name="pregnantEmotion" value="52"/>其他
                    备注：<input class="input-text" type="text" id="pregnantEmotionRemark" name="pregnantEmotionRemark"/>
                </td>
            </tr>
            <tr>
                <td class="firstTd">生产方式：</td>
                <td align="left" colspan="5">
                    <input type="radio" name="productionMethod" id="productionMethod1" value="53"/>顺产
                    <input type="radio" name="productionMethod" id="productionMethod2" value="54"/>剖腹产
                    <input type="radio" name="productionMethod" id="productionMethod3" value="55"/>顺转剖
                </td>
            </tr>
            <tr>
                <td class="firstTd">生产期间特殊情况：</td>
                <td align="left" colspan="5">
                    <input type="checkbox" name="productionSpecialSituation" value="56"/>缺氧难产
                    <input type="checkbox" name="productionSpecialSituation" value="57"/>脐带绕颈
                    <input type="checkbox" name="productionSpecialSituation" value="58"/>胎儿过大
                    <input type="checkbox" name="productionSpecialSituation" value="59"/>宫缩乏力
                    <input type="checkbox" name="productionSpecialSituation" value="60"/>胎盘早期剥离
                    <input type="checkbox" name="productionSpecialSituation" value="64"/>产程延长<input type="checkbox"
                                                                                                    name="productionSpecialSituation"
                                                                                                    value="62"/>胎膜早破
                    <input type="checkbox" name="productionSpecialSituation" value="63"/>宫内感染
                    <input type="checkbox" name="productionSpecialSituation" value="64"/>羊水栓塞
                </td>
            </tr>
            <tr>
                <td class="firstTd">产后情况：</td>
                <td align="left" colspan="5">
                    <input type="checkbox" name="afterProductionSituation" value="65"/>产后抑郁
                    <input type="checkbox" name="afterProductionSituation" value="66"/>产后大出血
                    <input type="checkbox" name="afterProductionSituation" value="67"/>产后精神病
                    <input type="checkbox" name="afterProductionSituation" value="68"/>其他
                    备注：<input class="input-text" type="text" id="afterProductionRemark" name="afterProductionRemark"/>
                </td>
            </tr>
            <tr>
                <td class="firstTd">主要照料者：</td>
                <td align="left" colspan="5">
                    <input type="checkbox" name="mainCaregiver" value="69"/>保姆
                    <input type="checkbox" name="mainCaregiver" value="70"/>亲生父母
                    <input type="checkbox" name="mainCaregiver" value="71"/>养父母
                    <input type="checkbox" name="mainCaregiver" value="72"/>爷爷奶奶
                    <input type="checkbox" name="mainCaregiver" value="73"/>外公外婆
                </td>
            </tr>
            <tr>
                <td class="firstTd">意外身体伤害：</td>
                <td align="left" colspan="5">
                    <input type="checkbox" name="accidentPhysicalInjury" value="74"/>严重摔伤
                    <input type="checkbox" name="accidentPhysicalInjury" value="75"/>休克
                    <input type="checkbox" name="accidentPhysicalInjury" value="76"/>癫痫
                    <input type="checkbox" name="accidentPhysicalInjury" value="77"/>其他
                    备注：<input class="input-text" type="text" id="physicalInjuryRemark" name="physicalInjuryRemark"/>
                </td>
            </tr>
            <tr>
                <td class="firstTd">意外家庭变动：</td>
                <td align="left" colspan="5">
                    <input type="checkbox" name="accidentFamilyChanges" value="78"/>父母离异
                    <input type="checkbox" name="accidentFamilyChanges" value="79"/>亲人去世
                    <input type="checkbox" name="accidentFamilyChanges" value="80"/>其他
                    备注：<input class="input-text" type="text" id="familyChangesRemark" name="familyChangesRemark"/>
                </td>
            </tr>
            <tr>
                <td class="firstTd">一类疫苗：</td>
                <td align="left" colspan="5">
                    <input type="checkbox" name="oneTypeVaccines" value="81"/>卡介苗
                    <input type="checkbox" name="oneTypeVaccines" value="82"/>脊髓灰质炎疫苗
                    <input type="checkbox" name="oneTypeVaccines" value="83"/>麻疹疫苗
                    <input type="checkbox" name="oneTypeVaccines" value="84"/>百白破疫苗
                    <input type="checkbox" name="oneTypeVaccines" value="85"/>乙肝疫苗
                </td>
            </tr>
            <tr>
                <td class="firstTd">二类疫苗：</td>
                <td align="left" colspan="5">
                    <input type="checkbox" name="twoTypeVaccines" value="86"/>流脑疫苗
                    <input type="checkbox" name="twoTypeVaccines" value="87"/>麻腮风三联
                    <input type="checkbox" name="twoTypeVaccines" value="88"/>水痘
                    <input type="checkbox" name="twoTypeVaccines" value="89"/>肺炎球菌
                    <input type="checkbox" name="twoTypeVaccines" value="90"/>流感
                    <input type="checkbox" name="twoTypeVaccines" value="91"/>甲肝疫苗
                </td>
            </tr>
            <tr>
                <td class="firstTd">其他疫苗：</td>
                <td align="left" colspan="5">
                    <input class="input-text" type="text" id="otherVaccines" name="otherVaccines" style="width:500px;"/>
                </td>
            </tr>
            <tr>
                <td class="firstTd">食物过敏：</td>
                <td align="left" colspan="5">
                    <input type="checkbox" name="foodAllergy" value="92"/>鸡蛋
                    <input type="checkbox" name="foodAllergy" value="93"/>牛奶
                    <input type="checkbox" name="foodAllergy" value="94"/>坚果
                    <input type="checkbox" name="foodAllergy" value="95"/>花生
                    <input type="checkbox" name="foodAllergy" value="96"/>黄豆
                    <input type="checkbox" name="foodAllergy" value="97"/>鱼
                    <input type="checkbox" name="foodAllergy" value="98"/>大米
                    <input type="checkbox" name="foodAllergy" value="99"/>其他
                    备注：<input class="input-text" type="text" id="foodAllergyRemark" name="foodAllergyRemark"/>
                </td>
            </tr>
            <tr>
                <td class="firstTd">吸入性敏：</td>
                <td align="left" colspan="5">
                    <input type="checkbox" name="breathAllergy" value="100"/>扬尘
                    <input type="checkbox" name="breathAllergy" value="101"/>尘螨
                    <input type="checkbox" name="breathAllergy" value="102"/>香精
                    <input type="checkbox" name="breathAllergy" value="103"/>花粉
                    <input type="checkbox" name="breathAllergy" value="104"/>其他
                    备注：<input class="input-text" type="text" id="breathAllergyRemark" name="breathAllergyRemark"/>
                </td>
            </tr>
            <tr>
                <td class="firstTd">接触性过敏：</td>
                <td align="left" colspan="5">
                    <input type="checkbox" name="contactAllergy" value="105"/>紫外线
                    <input type="checkbox" name="contactAllergy" value="106"/>洗洁精
                    <input type="checkbox" name="contactAllergy" value="107"/>特定金属制品
                    <input type="checkbox" name="contactAllergy" value="108"/>化纤制品
                    <input type="checkbox" name="contactAllergy" value="109"/>其他
                    备注：<input class="input-text" type="text" id="contactAllergyRemark" name="contactAllergyRemark"/>
                </td>
            </tr>
            <tr>
                <td class="firstTd">肢体缺失：</td>
                <td align="left" colspan="5">
                    <input type="checkbox" name="limbDeletion" value="110"/>面部（五官）
                    <input type="checkbox" name="limbDeletion" value="111"/>上肢
                    <input type="checkbox" name="limbDeletion" value="112"/>手指
                    <input type="checkbox" name="limbDeletion" value="113"/>下肢
                    <input type="checkbox" name="limbDeletion" value="114"/>脚趾
                    <input type="checkbox" name="limbDeletion" value="115"/>其他
                    备注：<input class="input-text" type="text" id="limbDeletionRemark" name="limbDeletionRemark"/>
                </td>
            </tr>
            <tr>
                <td class="firstTd">医学检查：</td>
                <td align="left" colspan="5">
                    <input type="checkbox" name="medicalExamination" value="116"/>核磁
                    <input type="checkbox" name="medicalExamination" value="117"/>CT
                    <input type="checkbox" name="medicalExamination" value="118"/>行为筛查
                    <input type="checkbox" name="medicalExamination" value="119"/>听统筛查
                    <input type="checkbox" name="medicalExamination" value="120"/>发育水平评估
                    <input type="checkbox" name="medicalExamination" value="121"/>其他
                    备注：<input class="input-text" type="text" id="medicalExaminationRemark"
                              name="medicalExaminationRemark"/>
                </td>
            </tr>
            </tbody>
        </table>

    </form>

    <div class="row">
        <div class="col-sm-offset-5 col-sm-10">
            <button type="button" class="btn btn-sm btn-primary" onclick="submitHandler()"><i class="fa fa-check"></i>保
                存
            </button>&nbsp;
            <button type="button" class="btn btn-sm btn-danger" onclick="closeItem()"><i class="fa fa-reply-all"></i>关 闭
            </button>
        </div>
    </div>

</div>
<th:block th:include="include :: footer"/>
<th:block th:include="include :: summernote-js"/>
<th:block th:include="include :: select2-js"/>
<th:block th:include="include :: bootstrap-select-js"/>
<th:block th:include="include :: datetimepicker-js"/>
<script th:inline="javascript">

    var prefix = ctx + "business/childInformation";

    function submitHandler() {
        if ($.validate.form()) {
            var data = $("#formData").serializeArray();
            $.operate.saveTab(prefix + "/saveInformation", data);
        }
    }

</script>
</body>

</html>